Provider Demographics
NPI:1942362546
Name:MOLCZYK, DOROTHY RUTH (LMHP PLADC)
Entity Type:Individual
Prefix:MRS
First Name:DOROTHY
Middle Name:RUTH
Last Name:MOLCZYK
Suffix:
Gender:F
Credentials:LMHP PLADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1218 K STREET
Mailing Address - Street 2:SUITE B
Mailing Address - City:AURORA
Mailing Address - State:NE
Mailing Address - Zip Code:68818
Mailing Address - Country:US
Mailing Address - Phone:402-694-3366
Mailing Address - Fax:402-694-3766
Practice Address - Street 1:1218 K ST
Practice Address - Street 2:SUITE B
Practice Address - City:AURORA
Practice Address - State:NE
Practice Address - Zip Code:68818
Practice Address - Country:US
Practice Address - Phone:402-694-3366
Practice Address - Fax:402-694-3766
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2187101YM0800X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025208300Medicaid
NE47052851513Medicaid
NE47052851507Medicaid
NE85287OtherBLUE CROSS BLUE SHIELD
NE246089OtherMIDLANDS CHOICE
NE47080857027Medicaid
NE84970OtherBLUE CROSS BLUE SHIELD
NE100252089Medicaid